Code of Federal Regulations Title 48. Federal Acquisition Regulations System 48.1615.406-2 Certificates of accurate cost or pricing data for community rated carriers

(Beginning of first certificate)

Certificate of Accurate Cost or Pricing Data for Community–Rated Carriers (SSSG methodology)

This is to certify that, to the best of my knowledge and belief:  (1) The cost or pricing data submitted (or, if not submitted, maintained and identified by the carrier as supporting documentation) to the Contracting officer or the Contracting officer's representative or designee, in support of the __* FEHB Program rates were developed in accordance with the requirements of 48 CFR Chapter 16 and the FEHB Program contract and are accurate, complete, and current as of the date this certificate is executed;  and (2) the methodology used to determine the FEHB Program rates is consistent with the methodology used to determine the rates for the carrier's Similarly Sized Subscriber Group.

* Insert the year for which the rates apply.

Firm: __________

Name: __________

Signature: __________

Date of Execution: __________

(End of first certificate)

(Beginning of second certificate)

Certificate of Accurate Cost or Pricing Data for Community–Rated Carriers (MLR methodology)

This is to certify that, to the best of my knowledge and belief:  (1) The cost or pricing data submitted (or, if not submitted, maintained and identified by the carrier as supporting documentation) to the Contracting officer or the Contracting officer's representative or designee, in support of the _____*FEHB Program rates were developed in accordance with the requirements of 48 CFR Chapter 16 and the FEHB Program contract and are accurate, complete, and current as of the date this certificate is executed;

* Insert the year for which the rates apply.

Firm:  

Name:  

Signature:  

Date of Execution:  

(End of second certificate)

(Beginning of third certificate)

Certificate of Accurate MLR Calculation

This is to certify that, to the best of my knowledge and belief:  the determination of the carrier's FEHB–specific medical loss ratio for * is accurate, complete, and consistent with the methodology as stated in § 1615.402(c)(3)(ii).

* Insert the year for which the MLR calculation applies.

Firm:  

Name:  

Signature:  

Date of Execution:  

(End of certificate)